Predictors of severity factors associated with severe scrub typhus among children in a Tertiary Care Hospital

Subhasmita Panda; Kalpana Panda; Subrat Kumar Swain; Medha Gupta; Rachita Sarangi

doi:10.4103/JVBD.JVBD_56_24

Predictors of severity factors associated with severe scrub typhus among children in a Tertiary Care Hospital

J Vector Borne Dis. 2024 Oct 5. doi: 10.4103/JVBD.JVBD_56_24. Online ahead of print.

Authors

Subhasmita Panda¹, Kalpana Panda¹, Subrat Kumar Swain², Medha Gupta¹, Rachita Sarangi¹

Affiliations

¹ Department of Pediatrics, IMS and SUM Hospital, Siksha 'O' Anusandhan (deemed to be) University, K8, Kalinga Nagar, Bhubaneswar, Odisha, India.
² Medical Research Laboratory, IMS and SUM Hospital, Siksha 'O' Anusandhan (deemed to be) University, K8, Kalinga Nagar, Bhubaneswar, Odisha, India.

PMID: 39808781
DOI: 10.4103/JVBD.JVBD_56_24

Abstract

Background objectives: Scrub typhus is an acute febrile zoonotic disease caused by the obligate intracellular gram-negative bacteria Orientia tsutsugamushi. Growing data over the last few years on the Indian subcontinent suggest that it is one of the most widespread but under-reported diseases. The study aimed to document the clinical and paraclinical profile and evaluate complications of scrub typhus in severe and nonsevere pediatric age groups.

Methods: A prospective observational study was conducted in pediatric patients. Frequency, mean, percentage and standard deviation were all included in the descriptive statistical analysis calculation. Multivariate analysis was conducted to predict the severity factor.

Results: A total of 189 patients met the eligibility criteria and were included in the final analysis. The mean and standard deviation (mean ± SD) age of the cohort was 5.54 ± 3.9 years, with a male predominance of 68.2%. The mean ± SD duration of fever was 6.64 ± 1.43 days. Patients with severe scrub typhus experienced complications including hepatic involvement (42, 64.6%), respiratory distress (23, 46.1%), neurological involvement (14, 24.6%), acute kidney injury (10, 15.4%), myocarditis (9, 13.8%), and (16, 24.6%) have multi-organ dysfunction. patients with raised transaminases (> 180 IU/L) have a 3.7 to 4.1 times greater chance of developing severity. Thrombocytopenia is found to be another independent predictor of severe scrub typhus in our study.

Interpretation conclusion: Clinical signs of hepatomegaly, skin rash, and lymphadenopathy were significant predictors of severity. Delays in treatment are a key contributor to the severity of pediatric scrub typhus.